Healthcare Freelance Editor and Professor at Drexel University Kline School of Law & Dornsife School of Public Health

More by Robert I. Field, Ph.D., J.D., M.P.H.

President Obama uttered almost 7,000 words in his State of the Union address Tuesday night. By my count, he directed only 208 of them to health reform. That’s about three percent of the speech focused on his signature policy initiative.

He used almost a third of those 208 words not to tout the law’s benefits but to concede its shortcomings. Here’s how he began - “So let me be the first to say that anything can be improved.”

What gives?

Maybe he wanted to avoid an extremely divisive issue to promote his theme of conciliation and bipartisanship. Republican attempts to repeal health reform have created the deepest partisan split so far in the new Congress.

Or, maybe he thought that other issues were more important. He wants to focus now on creating jobs and enhancing American competitiveness.

Or, maybe he wanted to distract attention from an initiative that many Americans still oppose. Some polls show that close to half the population continues to see the health reform law as a bad idea (see Washington Post/ABC News poll.

If this was his goal, he may have miscalculated.

While many people dislike the law, most polls show that only a minority favors repeal. The reasons aren’t entirely clear, but it seems likely that many people do not want Congress to revisit last year’s battles. They may also want to give the law a chance to work before throwing it in the scrap heap. And many of those who disapprove of the law are against repeal because they want health reform to go farther.

In fact, many parts of the law remain highly popular, especially the consumer protections. A large percentage even approves of the law’s most controversial provision, the mandate that requires everyone to have health insurance, when it is placed in context. While most give the mandate a thumbs down when they are asked about it in isolation, opinions are more evenly split when pollsters present it as a necessary element in forcing insurers to cover everyone.

Voter reactions to health reform played an important role in last fall’s election. Neither Obama nor fellow Democrats said very much about the law, and the results didn’t go their way. Health reform is likely to remain on voters’ minds in 2012. You’d think the President would be doing more to bolster public support.

It’s hard to build enthusiasm for an initiative whose creators won’t even come to its defense. Republicans are impassioned when they attack health reform. Everyone can sense it. If President Obama wants the issue to play out differently in 2012 than it did in 2010, he needs to show the same fervor.

The public seems ready to hear what he has to say. He just has to say it.